基于FBXO31的慢性乙型肝炎肝纤维化无创诊断模型的建立及评价  

Establishment and evaluation of a non-invasive diagnostic model for liver fibrosis in chronic hepatitis B based on FBXO31

作　　者：郑国军[1] 刘小琴[1] 张宏宇[1] 刘健红[2] ZHENG Guojun;LIU Xiaoqin;ZHANG Hongyu;LIU Jianhong(Department of Laboratory,Changzhou Third People's Hospital,Changzhou 213001,China;Department of Pathology,Changzhou Third People's Hospital,Changzhou 213001,China)

机构地区：[1]常州市第三人民医院检验科,213001 [2]常州市第三人民医院病理科,213001

出　　处：《国际消化病杂志》2022年第1期44-49,共6页International Journal of Digestive Diseases

摘　　要：目的探讨基于F-box蛋白31(FBXO31)构建的慢性乙型肝炎肝纤维化无创诊断模型的临床应用价值。方法前瞻性选取2019年3月至2021年1月在常州市第三人民医院就诊的164例慢性乙型肝炎患者作为研究对象。采用Ficoll密度梯度离心法分离外周血中单个核细胞,采用蛋白质印迹法检测单个核细胞中FBXO31的表达水平。采用logistic回归分析构建慢性乙型肝炎肝纤维化诊断模型,采用ROC曲线和决策树分析法评价该模型的诊断效能。结果根据肝纤维化病理分期标准,164例肝纤维化患者中S0期30例,S1期28例,S2期36例,S3期32例,S4期38例。S0期、S1期、S2期、S3期和S4期患者的FBXO31相对表达量分别为0.22±0.07、0.34±0.07、0.43±0.09、0.52±0.10和0.72±0.14,组间差异均有统计学意义(P均<0.05)。Spearman秩相关分析显示,FBXO31的相对表达量与肝纤维化病理分期呈正相关(r_(s)=0.877,P<0.05)。由FBXO31、ALT、AST和血小板(PLT)构成的模型X、模型Y和模型Z诊断慢性乙型肝炎肝纤维化病理分期的ROC曲线下面积均大于AST/PLT比值指数(APRI)和肝纤维化指数(FIB4),差异均有统计学意义(P均<0.05)。决策树分析结果显示,模型X、模型Y和模型Z对于慢性乙型肝炎肝纤维化病理分期的诊断均具有临床应用价值。结论外周血单个核细胞中FBX031的表达水平越高,提示慢性乙型肝炎患者的肝纤维化程度越严重。基于FBXO31构建的慢性乙型肝炎肝纤维化无创诊断模型对于肝纤维化病理分期≥S2期的诊断有较高价值,但在肝纤维化病理分期≥S3期和S4期的诊断中仍存在一定不足。Objective This paper aims to establish a non-invasive diagnostic model for liver fibrosis of chronic hepatitis B based on F-box protein 31(FBXO31)and to analyze the clinical application value of the model.Methods A total of 164 patients with chronic hepatitis B who were admitted to Changzhou Third People's Hospital from March 2019 to January 2021 were prospectively selected as the research subjects.Peripheral blood mononuclear cells were isolated by utilizing the Ficoll density gradient separation method,and the expression level of FBXO31 in mononuclear cells was detected by Western blotting.Logistic regression analysis was used to construct a diagnostic model for liver fibrosis of chronic hepatitis B.The ROC curve and decision tree were used to evaluate the effectiveness of the model.Results According to the pathological staging criteria of liver fibrosis,thirty of the 164 patients with liver fibrosis are in stage S0,twenty-eight in stage S1,thirty-six in stage S2,thirty-two in stage S3,and thirty-eight in stage S4.The relative expression levels of FBXO31 in the pathological stages of liver fibrosis S0,S1,S2,S3,and S4 are 0.22±0.07,0.34±0.07,0.43±0.09,0.52±0.10,and 0.72±0.14,respectively,with statistically significant differences between groups(P<0.05).The Spearman correlation analysis shows that the relative expression level of FBXO31 is positively correlated with the pathological stages of liver fibrosis(r_(s)=0.877,P<0.05).The areas under the ROC curve of model X,model Y,and model Z composed of FBXO31,ALT,AST and platelet(PLT)in the diagnosis of chronic hepatitis B liver fibrosis pathological staging are all bigger than those of AST/PLT ratio index(APRI)and fibrosis index of liver(FIB4),with a statistically significant difference(P<0.05).The decision tree results demonstrate that model X,model Y,and model Z have clinical application values in diagnosing the pathological staging of chronic hepatitis B liver fibrosis.Conclusions The higher the expression level of FBX031 is in peripheral blood mononuclear c

关 键 词：慢性乙型肝炎 肝纤维化 F-box蛋白31 无创诊断模型 

分 类 号：R575.2[医药卫生—消化系统] R512.62[医药卫生—内科学]